TENS - TRANSCUTANEOUS ELECTRICAL NERVE STIMULATIONS
Transcutaneous Electrical Nerve Stimulations (TENS) are safe non-invasive, drug-free methods of pain management. TENS is currently one of the most commonly used forms of electro- analgesia.The TENS device relieves pain by sending small electrical impulses through electrodes placed on the skin to underlying nerve fibers. TENS works by two different mechanisms:
- First, electrical stimulation of the nerve fibers can block a pain signal from being carried to the brain. If the signal is blocked, pain is not perceived.
- Secondly, the body has its own mechanism for suppressing pain. It does this by releasing natural compounds called endorphins which act as analgesics.
By effectively managing pain without drugs, TENS allows many people with chronic pain conditions, to resume normal daily activity. TENS has proven to be beneficial in the treatment of acute and chronic pain caused by pain related medical conditions. When TENS is used as an analgesic, patients are instructed to try different frequencies and intensities to find those that provide them with the best pain control. Optimal settings of stimulus parameters are subjective and are determined by trial and error. Electrode positioning is quite important. Electrodes are initially placed on the skin over the painful area, but other locations may give comparable or even better pain relief such as:
- over cutaneous nerves
- trigger points
- acupuncture sites
Patient comfort is a very important determinant of compliance and consequently the overall success of treatment. The intensity of the impulse is a function of pulse duration and amplitude. Greater pulse widths tend to be more painful.The amount of output current depends on the combined impedance of the electrodes, skin, and tissues.
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WHAT IS NMES THERAPY?
Neuromuscular electrical stimulation (NMES) is the application of electrical stimuli to a group of muscles, most often for the purpose of muscle rehabilitation. This technique is primarily used by physical therapists as a form of rehabilitation after injury, stroke, or other incident that results in the loss of muscle functions. NMES is achieved by passing an electrical impulse from a device through electrodes placed on the skin over the targeted muscle or muscles.
For the purpose of rehabilitation, neuromuscular electrical stimulation is typically used in conjunction with other methods of physical therapy. The intent of is to stimulate the nerves in the muscle with electrical impulses, since they are a natural part of the normal communication between the brain and the muscular system in an uninjured or unaffected body. With this therapy, these natural impulses are simulated and can help “retrain” the muscles to function again.
Even with the use of NMES, most rehabilitation patients must also undergo physical therapy to prevent muscles from atrophying, or dying. In some cases, depending on the cause and extent of injury, other forms of electrical stimulation therapy may also be used. Similarly, the same electrical technology is used to measure the performance of nerves and muscles for diagnostic purposes and measuring improvement.
WHAT IS EMS OR PMS?
- damage to bones
- joints, muscles
- ligaments and tendons
Transcutaneous Electrical Nerve Stimulations (TENS) are safe non-invasive, drug-free methods of pain management. TENS is currently one of the most commonly used forms of electro- analgesia. The TENS device relieves pain by sending small electrical impulses through electrodes placed on the skin to underlying nerve fibers. TENS works by two different mechanisms.
First, electrical stimulation of the nerve fibers can block a pain signal from being carried to the brain. If the signal is blocked, pain is not perceived.
Secondly, the body has its own mechanism for suppressing pain. It does this by releasing natural compounds called endorphins which act as analgesics.
By effectively managing pain without drugs, TENS allows many people with chronic pain conditions, to resume daily activity. TENS has proven to be beneficial in the treatment of acute and chronic pain caused by pain related medical conditions. When TENS is used as an analgesic, patients are instructed to try different frequencies and intensities to find those that provide them with the best pain control. Optimal settings of stimulus parameters are subjective and are determined by trial and error.
Electrical Muscle Stimulator (EMS), now called Powered Muscle Stimulator (PMS) is intended to stimulate healthy muscles in order to improve or facilitate muscle performance.
1. Relaxation of muscle spasms
2. Prevention or retardation of disuse atrophy
3. Increasing local blood circulation
4. Muscle conditioning
5. Immediate post-surgical stimulation of calf muscles to prevent venous
thrombosis
6. Maintaining or increasing range of motion
WHAT IS NEUROSTIMULATOR THERAPY?
Neurostimulation provides pain relief by blocking the pain messages before they reach the brain. The neurostimulator sends out mild electrical impulses that reach the brain faster than the pain signal can arrive. In other words, it outsmarts your pain. Instead of pain, you feel a tingling sensation.
A neurostimulator is a surgically implanted device about the size of a small stopwatch. It delivers mild electrical signals to the epidural area near your spine through one or more thin wires, called leads. The electrical signals cause a tingling sensation in the area of your chronic pain.
You can adjust the strength and location of stimulation using a handheld programmer. For example, you can regulate different levels of stimulation at different times of the day or for various activities – such as walking, sleeping, or sitting. When using a neurostimulator, can automatically adjust stimulation when you are upright (sitting or standing), lying down, or active while in an upright position.
A COMPLETE NEUROSTIMULATION SYSTEM INCLUDES SEVERAL COMPONENTS:
- Neurostimulator – The device that generates the electrical impulses (usually placed under the skin in your abdomen or upper buttock)
- Leads – Thin, insulated medical wires that deliver electrical pulses to the epidural space near the spine
- Physician’s programmer – A computer at your doctor’s office that lets your doctor adjust the neurostimulation system and its settings
- Patient’s programmer – A handheld device you can use at home to customize the stimulation (within the settings your doctor has selected)
The neurostimulation system does not make any noise. It may be felt as a small bump under your skin, but does not normally show through your clothes.
NEUROSTIMULATION PROVIDES ADVANTAGES OVER OTHER THERAPIES FOR CHRONIC PAIN:
- Unlike other chronic pain treatments or surgeries, you can experience neurostimulation and see if it relieves your pain before committing to the long-term therapy.
- A screening test serves as a temporary evaluation period. The screening test is much like an injection, but instead of medication being placed into the epidural space, leads are positioned and connected to an external neurostimulator (battery pack)
- It does not have to be a permanent procedure. The neurostimulator can be surgically removed if you do not like it or if you decide to pursue a different treatment
- Unlike oral medications that circulate throughout your entire body, neurostimulation targets the precise area where you are feeling pain
- A neurostimulator may provide relief when other treatments – like medications or injections – have not
Neurostimulation may reduce your chronic pain and improve your ability to go about your daily activities. Talk to your doctor about the benefits and risks associated with using a neurostimulator for your chronic back and leg pain.